Patricia Dominique, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

RN268854 Issued in MA

Practice address

801 Massachusetts Ave
Crosstown 2ND Floor
Boston, MA 02118-2605

Phone

(617) 414-4376

Fax

(617) 414-4676

NPI assigned

Apr 2, 2017

Last updated

Sep 28, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Evans Medical Foundation IncGroup PAC ID 7416946546, 525 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pdominique99410@direct.bmc.masshiway.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Evans Medical Foundation, Inc.

  dba Boston University Internal Medicine Associates

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1912954124
  Medicare reassignment Care Compare group NPD
• Boston Medical Center Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1346218294
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506556800000",
    "number": "1760914386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE.,",
            "address_2": "DOB 503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MASSACHUSETTS AVE",
            "address_2": "CROSSTOWN 2ND FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182605",
            "telephone_number": "617-414-4376",
            "fax_number": "617-414-4676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINIQUE",
        "first_name": "PATRICIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-02",
        "last_updated": "2017-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "RN268854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110122168A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Domingo
• Kevin Anthony Domingos, PH.D.
• Carla Dominguez Gonzalez, MD
• Megan Dominguez, PHARM.D, RPH
• Laura S Dominici, M.D.
• Erica Dommasch, MD
• Kimiko Domoto-Reilly, MD
• Alexandra Doms, MD
• Christopher Michael Domush, MD
• Laura A Don, LCSW

• Gerontology Nurse Practitioner in Boston, MA
• Providers in Boston, MA by specialty
• Gerontology Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.